<html>
<form name="input" action="insert-contact.php" method="post"><br />
Firstname: <input type="text" name="fname"><br />
Surname: <input type="text" name="sname"><br />
Preferred name: <input type="text" name="pname"><br />
User EMail: <input type="text" name="user_email"><br />
Passcode: <input type="text" name="passcode"><br />
D.O.B.: <input type="text" name="dob"><br />
Needs: <input type="text" name="needs"><br />

<!--Hard coded user value-->

<br />
<input type="submit" value="Submit">
</form>
</html>